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Comprehensive evaluation of the toxicological effects of commonly encountered synthetic cathinones using in silico methods.
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-22 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfaf012
Can Özgür Yalçın, Sezen Yılmaz Sarıaltın, Giuseppa Raitano, Emilio Benfenati

Synthetic cathinones (SCs), a group of new psychoactive substances (NPS), are designer molecules with hallucinogenic and psychostimulatory effects. Although the structural similarities of SCs to amphetamines suggest that they may have similar toxicity profiles to those of amphetamine congeners, little is known about SCs from a toxicological point of view. In the present study, the toxicity profiles of commonly encountered SCs (n = 65), listed in the 2020 Report of the United Nations Office on Drugs and Crime (UNODC), were evaluated using in silico methods. We aimed to gain a deeper understanding of key toxicological endpoints: acute oral toxicity (LD50), mutagenicity, genotoxicity, and carcinogenicity prediction using EPA TEST (v.5.1.2 and 4.2.1), VEGA (v.1.2.3), and ProTox (v.3.0). Physicochemical and pharmacokinetic (ADME) properties were estimated using SwissADME and pkCSM. 2,3-MDMC (41) was predicted to be the most lethal SC by the VEGA KNN and the EPA TEST v.5.1.2 with an oral rat LD50 value of 105.17 and 117.77 mg/kg, respectively. 4-BEC (2) was the only molecule with a consensus score of positive prediction greater than 0.90 in both TEST mutagenicity models. 2,3-MDMC (41) and methylone (52) were predicted as carcinogenic by VEGA carcinogenicity CAESAR, ISS, IRFMN-ISSCAN-CGX, oral classification, and ProTox models. These two SCs were predicted to be active by VEGA chromosomal aberration (CORAL) and in vitro micronuclei-inducing activity (IRFMN-VERMEER) models. Our results concluded that given the prolonged exposure duration and age range, the genotoxic and carcinogenic potential of SCs should be considered, among other known toxic effects.

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引用次数: 0
Climate friendly MOFs synthesis for drug delivery systems by integrating AI, intelligent manufacturing, and quantum solutions in industry 6.0 sustainable approach.
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-22 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfaf011
Maryam Akhtar, Hammad Majeed, Tehreema Iftikhar, Khalil Ahmad

Since the Industrial Revolution, ecological damage, ecosystem disruption, and climate change acceleration have frequently resulted from human advancement at the price of the environment. Due to the rise in illnesses, Industry 6.0 calls for a renewed dedication to sustainability with latest technologies. Focused research and creative solutions are needed to achieve the UN Sustainable Development Goals (SDGs), especially 3, 9, 13, 14, 15, 17. A promising sustainable technology for enhancing healthcare while reducing environmental effect is Metal Organic Frameworks (MOFs). MOFs are perfect for drug administration because of their high surface areas, adjustable pore sizes, and remarkable drug-loading capacities. They are created by combining advanced artificial intelligence, intelligent manufacturing, and quantum computing. Researchers can create MOFs with functional groups or ligands that bind selectively to target cells or tissues, minimizing off-target effects, thanks to the distinct benefits that families like MIL, HKUST, UiO, and ZIF etc. offer for targeted drug delivery. Combining MOFs with other nanomaterials results in multipurpose systems that can handle challenging biomedical issues. Despite its promise, there are still issues with MOFs' possible toxicity and long-term stability in physiological settings. To advance their medicinal applications, these problems must be resolved. Researchers can increase the usefulness of MOFs in medicine by critically analysing these limitations and putting up creative alternatives. The creation of MOFs especially with advanced technologies (additive manufacturing etc.) for drug delivery is a prime example of how scientific advancement and environmental stewardship may coexist to provide healthcare solutions that are advantageous to both people and the environment.

{"title":"Climate friendly MOFs synthesis for drug delivery systems by integrating AI, intelligent manufacturing, and quantum solutions in industry 6.0 sustainable approach.","authors":"Maryam Akhtar, Hammad Majeed, Tehreema Iftikhar, Khalil Ahmad","doi":"10.1093/toxres/tfaf011","DOIUrl":"10.1093/toxres/tfaf011","url":null,"abstract":"<p><p>Since the Industrial Revolution, ecological damage, ecosystem disruption, and climate change acceleration have frequently resulted from human advancement at the price of the environment. Due to the rise in illnesses, Industry 6.0 calls for a renewed dedication to sustainability with latest technologies. Focused research and creative solutions are needed to achieve the UN Sustainable Development Goals (SDGs), especially 3, 9, 13, 14, 15, 17. A promising sustainable technology for enhancing healthcare while reducing environmental effect is Metal Organic Frameworks (MOFs). MOFs are perfect for drug administration because of their high surface areas, adjustable pore sizes, and remarkable drug-loading capacities. They are created by combining advanced artificial intelligence, intelligent manufacturing, and quantum computing. Researchers can create MOFs with functional groups or ligands that bind selectively to target cells or tissues, minimizing off-target effects, thanks to the distinct benefits that families like MIL, HKUST, UiO, and ZIF etc. offer for targeted drug delivery. Combining MOFs with other nanomaterials results in multipurpose systems that can handle challenging biomedical issues. Despite its promise, there are still issues with MOFs' possible toxicity and long-term stability in physiological settings. To advance their medicinal applications, these problems must be resolved. Researchers can increase the usefulness of MOFs in medicine by critically analysing these limitations and putting up creative alternatives. The creation of MOFs especially with advanced technologies (additive manufacturing etc.) for drug delivery is a prime example of how scientific advancement and environmental stewardship may coexist to provide healthcare solutions that are advantageous to both people and the environment.</p>","PeriodicalId":105,"journal":{"name":"Toxicology Research","volume":"14 1","pages":"tfaf011"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between genetic variation rs57095329 of microRNA-146a and development of cognitive impairment after anesthesia: a case-control study in a Chinese Han population.
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-21 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfae227
Leijun Fan, Ru Wu, Yunyun Sun, Xia Li, Liang Chen, Jun Zhang, Chenghao Miao

The latest studies have demonstrated that aberrant expression of microRNA-146a is related to cognitive decline. The rs57095329 polymorphism occurring in the miR-146a promoter modulates its expression and causes downstream pathogenicity. A case-control study in a Chinese Han population was established to investigate the genetic association between the miR-146a rs57095329 polymorphism and postoperative cognitive dysfunction (POCD). 242 patients with POCD and another 238 non-POCD cases were enrolled in the case-control study. Serum miR-146a levels were detected by qRT-PCR. miR-146a rs57095329 polymorphism was genotyped using the ABI PRISM SNaPshot method. The genetic association between the rs57095329 polymorphism and POCD was assessed by regression analysis. No significant difference was detected for age, gender and BMI between POCD and non-POCD groups. MiR-146a rs57095329 polymorphism revealed significant generic associations with POCD in both dominant and recessive models, and the AA genotype may increase the risk of developing POCD. qRT-PCR indicated the upregulation of miR-146a level in POCD group. Serum levels of miR-146a and inflammatory factors were higher in rs57095329 AA genotype carriers than in AG/GG genotype carriers. Rs57095329 polymorphism was independently associated with the development of POCD. In conclusion, miR-146a rs57095329 polymorphism was associated with POCD in the Chinese Han population. The rs57095329 AA genotype was the causative genotype for POCD and was related to the upregulation of miR-146a and inflammatory factor levels.

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引用次数: 0
Investigating the link between microplastic exposure (benzyl butyl phthalate) and neurodegenerative diseases using high-performance computational toxicology. 使用高性能计算毒理学研究微塑料暴露(邻苯二甲酸苄丁酯)与神经退行性疾病之间的联系。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-18 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfae211
Alhamyani Abdulrahman

Background: Microplastics are tiny plastic particles, typically less than 5 mm in size, formed from the breakdown of larger plastic products. This breakdown releases additives, including benzyl butyl phthalate (BBP), into the environment. Humans can be exposed to BBP through contaminated food and water, inhalation, and dermal contact.

Aim: Research suggests that BBP, like other phthalates, may have neurotoxic effects, potentially contributing to neurodevelopmental disorders, though its specific toxic targets are not yet clear.

Methodology: In this study, high-performance computational methods were used to identify potential neurotoxic targets of BBP. The findings indicate that BBP has a strong potential to interact with Parkin (PRKN) and Pyruvate dehydrogenase lipoamide kinase isozyme 1 (PDK1), with binding scores of -5.35 kcal/mol, -5.56 kcal/mol, respectively. The PRKN and PDK1 BBP complexes were stable throughout the simulation period, as evidenced by the system's backbone exhibiting slight fluctuations and binding energies confirmed by molecular dynamics (MD) simulation trajectories.

Results: The MMPBSA analysis revealed free binding energies of -21.29 kcal/mol and - 27.06 kcal/mol for the PRKN and PDK1 BBP complexes, respectively. The interaction energies of BBP with PRKN and PDK1 were also within an acceptable range, at -113.68 ± 3.1 kJ/mol and - 117.54 ± 6.2 kJ/mol, respectively. Additionally, density-functional theory (DFT) based optimization showed negative values for the highest occupied molecular orbital (HOMO) -6.934 eV and lowest unoccupied molecular orbital (LUMO) -1.562 eV, indicating that BBP is energetically stable, which is crucial for forming a stable ligand-protein complex.

Conclusion: Overall, the computational investigation reveals that BBP has the potential to interact with PRKN and PDK1, leading to neurodegeneration.

背景:微塑料是微小的塑料颗粒,通常小于5毫米大小,由较大的塑料制品分解形成。这种分解释放出添加剂,包括邻苯二甲酸苄丁酯(BBP),进入环境。人类可以通过受污染的食物和水、吸入和皮肤接触接触到BBP。目的:研究表明,BBP和其他邻苯二甲酸盐一样,可能具有神经毒性作用,可能导致神经发育障碍,尽管其具体的毒性靶点尚不清楚。方法学:本研究采用高性能计算方法识别BBP的潜在神经毒性靶点。结果表明,BBP与Parkin (PRKN)和丙酮酸脱氢酶脂酰胺激酶同工酶1 (PDK1)具有很强的相互作用潜力,结合评分分别为-5.35 kcal/mol和-5.56 kcal/mol。在整个模拟过程中,PRKN和PDK1 BBP复合物是稳定的,系统的主链表现出轻微的波动,分子动力学(MD)模拟轨迹证实了结合能的变化。结果:MMPBSA分析显示PRKN和PDK1 BBP复合物的自由结合能分别为-21.29 kcal/mol和- 27.06 kcal/mol。BBP与PRKN和PDK1的相互作用能也在可接受范围内,分别为-113.68±3.1 kJ/mol和- 117.54±6.2 kJ/mol。此外,基于密度泛函理论(DFT)的优化结果显示,BBP的最高已占据分子轨道(HOMO)为-6.934 eV,最低未占据分子轨道(LUMO)为-1.562 eV为负值,表明BBP具有能量稳定性,这对于形成稳定的配体-蛋白复合物至关重要。结论:总体而言,计算研究显示BBP可能与PRKN和PDK1相互作用,导致神经退行性变。
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引用次数: 0
N-acetylcysteine prevents cholinergic and non-cholinergic toxic effects induced by nerve agent poisoning in rats. n-乙酰半胱氨酸可预防神经毒剂中毒引起的大鼠胆碱能和非胆碱能毒性作用。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-18 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfae223
Poorna Shri, K P Singh, Varsha Rani, D P Nagar, J Acharya, A S B Bhaskar

Objective: Organophosphorus Nerve Agent, VX [(O-Ethyl S-diisopropylaminomethyl) methylphosphonothioate] compound interferes with acetylcholine signaling by targeting the AChE enzyme. Studies suggest that in nerve agents poisoning, non-cholinergic effects are also responsible for damage in peripheral tissues including long term damage in brain. Present study reports cholinergic and non-cholinergic effects of VX poisoning and their prevention by use of N-acetylcysteine (NAC) in addition to conventional antidotes atropine sulphate and 2-PAM chloride as an antioxidant. NAC was chosen being an approved drug for medical conditions including oxidative damage and as mucolytic.

Results: Results of the study showed that after 1x LD 50 exposure to VX and standard atropine and oxime therapy resulted in recovery of cholinesterase activity up to 51%, while additional NAC administration resulted in increased recovery up to 89% in brain cholinesterase activity. NAC also helped in maintaining intracellular and tissue GSH level, reduced ROS generation and lipid peroxidation. NAC treatment could able to reduce the lipid peroxidation (MDA) levels in liver of NAC administered groups as compared to standard treatment of atropine sulphate and PAM chloride at 10 LD 50 VX. Likewise, a 20% higher level of GSH was found in NAC treated group at 1x LD 50 dose in brain. Cell cycle analysis and histopathological results showed that NAC prevents VX induced damage.

Conclusion: it was found that use of antioxidant agent NAC along with standard atropine-oxime treatment is helpful in reducing the cholinergic and oxidative stress mediated toxicity induced by VX.

目的:有机磷神经毒剂VX [(o -乙基s -二异丙基氨基甲基)甲基膦硫酸盐]化合物通过靶向乙酰胆碱AChE酶干扰乙酰胆碱信号。研究表明,在神经毒剂中毒中,非胆碱能效应也会导致外周组织的损伤,包括对大脑的长期损伤。本研究报道了VX中毒的胆碱能和非胆碱能效应,以及除常规解毒剂硫酸阿托品和2-PAM氯作为抗氧化剂外,n-乙酰半胱氨酸(NAC)的预防作用。NAC被选为一种被批准用于医疗条件的药物,包括氧化损伤和粘液溶解。结果:研究结果显示,暴露于1ld50 VX和标准阿托品和肟治疗后,胆碱酯酶活性恢复高达51%,而额外的NAC治疗可使脑胆碱酯酶活性恢复高达89%。NAC还有助于维持细胞内和组织GSH水平,减少ROS生成和脂质过氧化。与标准的10 ld50 VX硫酸阿托品和氯化PAM处理相比,NAC处理能够降低NAC给药组肝脏中脂质过氧化(MDA)水平。同样,1xld 50剂量NAC处理组脑内GSH水平升高20%。细胞周期分析和组织病理学结果表明,NAC可以预防VX引起的损伤。结论:抗氧化剂NAC联合标准阿托品肟治疗有助于降低VX所致的胆碱能和氧化应激毒性。
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引用次数: 0
Therapeutic effects and mechanisms of Juanbilijieqing fang in ameliorating gouty arthritis in a murine model. 蠲痹痹清方改善小鼠痛风性关节炎的疗效及机制研究。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-17 eCollection Date: 2025-02-01 DOI: 10.1093/toxres/tfaf005
Biao Zhou, Wei Li, Zhiqiang Luo, Liguo Zhu, Jie Yu, Yuxing Guo, Wangyang Li, Hui Xiong, Xiaolong Lu

This study aims to assess the safety, efficacy, and mechanisms of Juanbilijieqing Fang in a mouse model of gouty arthritis. C57BL/6 mice were allocated into six groups: control, gouty arthritis model, and treatment groups receiving varying doses of Juanbilijieqing Fang (low, medium, high), along with a positive control group treated with febuxostat. Gouty arthritis was induced via MSU crystal injection following a high-fat diet. Mice were treated with Juanbilijieqing Fang or febuxostat, and safety was evaluated by measuring spleen, kidney, and liver indices. Efficacy was assessed by monitoring foot thickness, pain threshold, and biochemical markers, including serum uric acid (UA), myeloperoxidase (MPO), xanthine oxidase (XOD), and adenosine deaminase (ADA). Serum pro-inflammatory cytokines were analyzed, and intestinal inflammation and barrier integrity were examined through histological and molecular assays. Juanbilijieqing Fang did not significantly affect spleen, kidney, or liver indices, indicating its safety. Therapeutically, it significantly reduced foot swelling, improved pain threshold, and decreased serum uric acid levels. It also lowered MPO activity in foot tissue and reduced XOD and ADA activity in the liver. Additionally, the formula downregulated pro-inflammatory cytokines, such as IL-1α, IL-1β, IL-6, TNF-α, and IFN-γ, demonstrating a strong anti-inflammatory effect. It ameliorated gut inflammation by decreasing NLRP3 inflammasome components (NLRP3, ASC, and Caspase-1) and enhanced gut mucosal integrity by upregulating ZO-1 and Occludin expression. Juanbilijieqing Fang is a safe and effective treatment for gouty arthritis, primarily through reducing systemic and intestinal inflammation and restoring gut barrier function.

本研究旨在评价蠲痹解清方对痛风性关节炎小鼠模型的安全性、有效性及其作用机制。将C57BL/6小鼠分为6组:对照组、痛风性关节炎模型组和不同剂量蠲痹解清方(低、中、高)治疗组,阳性对照组给予非布司他治疗。在高脂肪饮食后通过MSU晶体注射诱导痛风性关节炎。小鼠分别给予蠲痹痹清方或非布司他治疗,通过脾、肾、肝指标评价其安全性。通过监测足部厚度、疼痛阈值和生化指标(包括血清尿酸(UA)、髓过氧化物酶(MPO)、黄嘌呤氧化酶(XOD)和腺苷脱氨酶(ADA))来评估疗效。分析血清促炎细胞因子,并通过组织学和分子检测肠道炎症和屏障完整性。蠲痹解清方对脾、肾、肝指标均无显著影响,提示其安全性。治疗上,它显著减少足部肿胀,改善痛阈,降低血清尿酸水平。它还降低足部组织的MPO活性,降低肝脏中的XOD和ADA活性。此外,该配方下调促炎细胞因子,如IL-1α、IL-1β、IL-6、TNF-α和IFN-γ,显示出强大的抗炎作用。它通过降低NLRP3炎性小体成分(NLRP3、ASC和Caspase-1)来改善肠道炎症,并通过上调ZO-1和Occludin表达来增强肠道粘膜完整性。蠲痹痹清方是一种安全有效的治疗痛风性关节炎的药物,主要通过减少全身和肠道炎症,恢复肠道屏障功能。
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引用次数: 0
Inorganic arsenic modulates cell apoptosis by regulating Argonaute 2 expression via the p53 pathway. 无机砷通过p53通路调控Argonaute 2的表达,从而调控细胞凋亡。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI: 10.1093/toxres/tfae231
Kunyu Du, Jingkui Shu, Jintao Wu, Na Liu, He Ma, Jinyun Jiang, Yuefeng He, Xinan Wu

This study explores the role of Argonaute 2 (AGO2) in the induction of apoptosis by arsenic in 16HBE cells and investigates the association between AGO2 expression and arsenic exposure in a human population. By silencing AGO2 with siRNA, we examined its impact on cell viability and apoptosis using CCK-8, HO-PI, and JC-1 assays, complemented by qRT-PCR and Western blot analyses for gene and protein expressions. Our findings revealed a significant correlation between AGO2 expression and levels of exposure to inorganic arsenic (iAs), which was more pronounced than with other arsenic forms such as monomethylarsonic (MMA) and dimethylarsinic acids (DMA). The results showed that silencing AGO2 not only reduced cell viability but also intensified apoptosis, highlighting its role in activating the p53 pathway. This was further supported by increased phosphorylation of p53 at Ser392 and Thr55, reinforcing AGO2's involvement in apoptotic processes. The study underscores the potential of AGO2 as a therapeutic target in arsenic-related pathologies and highlights the critical need for managing occupational exposure to arsenic.

本研究探讨了砷诱导16HBE细胞凋亡中AGO2 (Argonaute 2)的作用,并探讨了AGO2表达与砷暴露之间的关系。通过siRNA沉默AGO2,我们使用CCK-8、HO-PI和JC-1检测其对细胞活力和凋亡的影响,并辅以qRT-PCR和Western blot分析基因和蛋白的表达。我们的研究结果揭示了AGO2表达与无机砷(iAs)暴露水平之间的显著相关性,这种相关性比其他形式的砷(如单甲基larsonic (MMA)和二甲基larsinic acid (DMA))更为明显。结果表明,沉默AGO2不仅降低了细胞活力,而且加剧了细胞凋亡,突出了其在激活p53通路中的作用。p53的Ser392和Thr55位点磷酸化增加进一步支持了这一点,强化了AGO2参与凋亡过程。该研究强调了AGO2作为砷相关病理治疗靶点的潜力,并强调了管理职业砷暴露的迫切需要。
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引用次数: 0
Therapeutic potential of Achillea millefolium L. extract on 7,12-dimethylbenz(a)anthracene (DMBA) -induced ovary cancer in Wistar rats: a biochemical, molecular and histopathological approach. 千叶水蛭提取物对7,12-二甲基苯(a)蒽(DMBA)诱导的Wistar大鼠卵巢癌的治疗潜力:生化,分子和组织病理学方法。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-08 eCollection Date: 2025-01-01 DOI: 10.1093/toxres/tfae235
Linsen Zhang, Xiu Yuan, Qingmei Peng

Ovarian cancer (OC) is a significant cause of cancer-related mortality among women. This study explores the efficacy of Achillea millefolium L. (A. millefolium) extract, known for its phytoestrogenic properties, in treating OC through hormonal and metabolic modulation. Using a Wistar rat model, OC was induced with 7,12-dimethylbenz(a)anthracene (DMBA), and the effects of A. millefolium, both alone and in combination with paclitaxel (PTX), were evaluated. The study involved five groups of ten rats each: normal, OC, and those receiving 100 mg/kg of A. millefolium with or without PTX. Key hormonal levels, oxidative stress markers, and inflammatory cytokines were measured. Additionally, ovarian tissues were analyzed for malondialdehyde and ferric reducing ability of plasma, while gene and protein expressions related to apoptosis were assessed. Results showed that A. millefolium, particularly when combined with PTX, reduced the luteinizing hormone/follicle-stimulating hormone ratio, increased antioxidant enzyme activity, and upregulated apoptosis-related pathways, leading to higher p53 expression and fewer Ki-67 positive cells. These findings suggest A. millefolium's potential as a complementary therapy for women with OC, particularly those with ovulation disorders.

卵巢癌(OC)是女性癌症相关死亡的重要原因。本研究探讨了以其植物雌激素特性而闻名的千叶阿喀琉叶提取物通过激素和代谢调节治疗OC的功效。采用Wistar大鼠模型,采用7,12-二甲基苯(a)蒽(DMBA)诱导大鼠OC,观察千叶合用紫杉醇(PTX)和单用两种药物的作用。该研究涉及五组大鼠,每组10只:正常,OC和接受100mg /kg含或不含PTX的千叶。测量了关键激素水平、氧化应激标志物和炎症细胞因子。此外,对卵巢组织进行血浆丙二醛和铁还原能力分析,同时评估与细胞凋亡相关的基因和蛋白表达。结果表明,尤其是与PTX联合使用时,千叶黄体生成素/促卵泡激素比值降低,抗氧化酶活性增加,凋亡相关通路上调,导致p53表达升高,Ki-67阳性细胞减少。这些发现表明,千叶草有潜力作为卵巢癌女性的补充疗法,特别是那些有排卵障碍的女性。
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引用次数: 0
A randomized, clinical trial of intravenous N-acetylcysteine as an antioxidant therapy in acute organophosphorus pesticide poisoning. 静脉注射n -乙酰半胱氨酸抗氧化治疗急性有机磷农药中毒的随机临床试验
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-08 eCollection Date: 2025-01-01 DOI: 10.1093/toxres/tfae234
Sarah S Mohammed, Ayman Zaaqoq, Shimaa Talaat, Salma I Abdelkader

The incidence of acute organophosphate (OP) poisoning has steadily increased in developing countries. Many studies showed that oxidative stress could have a significant role in its mechanism. The current study aimed to evaluate the role of N acetylcysteine (NAC) as an antioxidant in acute OP poisoned. A randomized, controlled, parallel-group trial was conducted in the period from the beginning of January 2022 to the end of June 2022. The study included 56 acute OP poisoned patients admitted to the intensive care unit (ICU) at the Poison Control Center of Ain Shams University Hospitals within 6 h after the exposure. The patients were randomly allocated in two equal groups; group (A): received the standard treatment plus NAC in a total dose of 300 mg/kg administered intravenously (IV) while group (B) received the standard treatment. Then both groups were compared as regards clinical parameters, laboratory investigations, ECG, and outcomes. Baseline parameters were comparable between the groups. However, NAC treatment significantly elevated concentrations of both serum catalase and glutathione peroxidase levels at 24 h, it did not significantly affect the total dose of atropine required, duration of atropine and oximes treatment or need for mechanical ventilation, and length of hospital stay. Mortality was lower in the NAC group (2 out of 28) than the standard treatment-only group (5 out of 28) but the difference was not statistically significant. This trial found that NAC improved antioxidant enzyme levels including serum CAT and GPX but did not affect clinically relevant outcomes.

在发展中国家,急性有机磷(OP)中毒的发病率稳步上升。许多研究表明,氧化应激可能在其机制中起重要作用。本研究旨在评价N -乙酰半胱氨酸(NAC)在急性OP中毒中的抗氧化作用。在2022年1月初至2022年6月底期间进行了一项随机、对照、平行组试验。该研究包括56例急性OP中毒患者,这些患者在接触后6小时内入住艾因沙姆斯大学医院中毒控制中心重症监护病房(ICU)。患者随机分为两组;A组:给予标准治疗加NAC,总剂量为300 mg/kg,静脉(IV)给药;B组给予标准治疗。然后比较两组的临床参数、实验室检查、心电图和结果。两组间基线参数具有可比性。然而,NAC治疗显著提高了24 h时血清过氧化氢酶和谷胱甘肽过氧化物酶的浓度,但对所需的阿托品总剂量、阿托品和肟治疗的持续时间或机械通气的需要以及住院时间没有显著影响。NAC组的死亡率(2 / 28)低于标准治疗组(5 / 28),但差异无统计学意义。本试验发现NAC可提高抗氧化酶水平,包括血清CAT和GPX,但不影响临床相关结果。
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引用次数: 0
The performance of ejection fraction as a predictor of mortality and morbidity in acute aluminium phosphide poisoning. 射血分数作为急性磷化铝中毒死亡率和发病率的预测指标。
IF 2.2 4区 医学 Q3 TOXICOLOGY Pub Date : 2025-01-08 eCollection Date: 2025-01-01 DOI: 10.1093/toxres/tfae232
Meray Medhat Shokry Zaghary, Hasnaa Ahmed Ahmed Ali, Asmaa Mohammed Khalaf Ahmed

Aluminium phosphide poison become an alarming, well-known, effective suicidal poison with a high mortality rate. There is a need for a simple tool that can triage patients with bad prognosis. The study aimed to assess the accuracy of ejection fraction as a predictor of mortality and morbidity in acute aluminium phosphide toxicity cases. The study involved 70 cases of acutely aluminium phosphide-poisoned patients in our hospital from January 2021 to January 2024. The study found that 54.3% of the cases were males and 45.7% were females, with a mean age of 22.4 ± 11.8 years old. The oral route was the route of administration of all cases, and the intention of poisoning was intentional in 84.3% of cases. Regarding the outcome of patients, 62.9% of the cases recovered, and 37.1% died. The Receiver Operating Characteristic Curve found that the ejection fraction below 37.5% had an accuracy rate of 96.8% with excellent discrimination for mortality, sensitivity of 100%, specificity of 93.2%, positive predictive value of 89.6%, and negative predictive value of 100%. The ejection fraction below 52.5% had an accuracy rate of 89% with good discrimination for complications, sensitivity of 83.3%, specificity of 96.8%, positive predictive value of 90.9%, and negative predictive value of 93.7%. So, the ejection fraction plays an essential tool in predicting mortality and complications in acute aluminium phosphide toxicity and should be assessed on every patient in the first 24 h of admission to facilitate the triage of these patients.

磷化铝毒是一种令人担忧的、众所周知的、具有高死亡率的有效自杀毒药。需要一种简单的工具来对预后不良的患者进行分类。该研究旨在评估射血分数作为急性磷化铝中毒病例死亡率和发病率预测因子的准确性。本研究纳入我院2021年1月至2024年1月急性磷酸铝中毒患者70例。男性占54.3%,女性占45.7%,平均年龄22.4±11.8岁。所有病例均以口服给药方式给药,84.3%的病例故意中毒。从患者的预后来看,62.9%的患者痊愈,37.1%的患者死亡。受试者工作特征曲线发现,射血分数低于37.5%时,准确率为96.8%,对死亡的判别良好,敏感性为100%,特异性为93.2%,阳性预测值为89.6%,阴性预测值为100%。射血分数低于52.5%,准确率89%,对并发症的鉴别良好,敏感性为83.3%,特异性为96.8%,阳性预测值为90.9%,阴性预测值为93.7%。因此,射血分数是预测急性磷化铝中毒的死亡率和并发症的重要工具,应在入院前24小时对每位患者进行评估,以促进这些患者的分诊。
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Toxicology Research
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